Effect of Egg White Elimination Diet on Clinical Progress and Specific IgE Levels in Egg White Sensitized Children with Atopic Dermatitis

Abstract

Purpose : Food allergies play a major role in childhood atopic dermatitis. Egg white is the most common causative allergen in IgE mediated food allergies, and the only treatment is complete elimination of egg white from diet. The purpose of this study is to evaluate the effect of an egg white elimination diet on clinical progress and egg white-specific IgE concentration in childhood atopic dermatitis.

Method : In 20 children with mild to severe atopic dermatitis, clinical progress was monitored by Jakob´s* atopic dermatitis grading system, and serum specific-IgE levels to six common food allergens and two house durst mites were measured by CAP-FEIA.

Results : In the study subjects, eight patients had been exposed to egg before diagnosis. During the six to 48 months of egg white elimination diet, clinical symptoms and signs were improved in 15 out of 20 patients. However, egg white-specific IgE levels were reduced by less than 1.20 kU/L(the cut off level suggesting immunological tolerance) in only seven patients. In the five patients with clinically persistent atopic dermatitis, egg white-specific IgE levels were 10.6-100 kU/L and house dust mite-specific IgE levels were 25.9-100 kU/L at the time of final examination.

Conclusion : After 6-48 months of the egg white elimination diet, 75% of egg allergic infants and children with atopic dermatitis showed clinical improvement of atopic denmatitis. However, it is suggested that the patients need more than 1-3 years of a complete elimination diet to obtain immunological tolerance determined by egg white-specific IgE levels.